CLIA lab
CLIA 05D1084391: Mact Medical San Andreas
San Andreas, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1084391 belongs to Mact Medical San Andreas in San Andreas, CA.
Certificate of Waiver, effective May 21, 2026, expires May 20, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- May 21, 2026
- Certificate expiration
- May 20, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 21, 2008
- Facility type
- Community clinic
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D1084391
- Lab name
- Mact Medical San Andreas
- Address
- 1113 Hwy 49, San Andreas, CA 95249
- Phone
- (209) 754-6262
- Fax
- (209) 674-6200
Annual test volume the lab reported
- Waived tests
- 199
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in San Andreas, CA
- Calaveras County Health DepartmentCertificate of Waiver, Other05D0609784
- California Forensic Medical Group IncCertificate of Waiver, Other05D2155235
- Family Medical Center - San AndreasCertificate for Provider-Performed Microscopy Procedures, Rural health clinic05D2001819
- Golden State Amdreas Care CenterCertificate of Waiver, Skilled nursing or nursing facility05D0662754
- Mact Dental, San AndreasCertificate of Waiver, Ancillary test site05D2216019
- Mark Twain Medical CenterCertificate of Accreditation, Hospital05D0609782
- Stockton Cardiology Medical Group - San AndreasCertificate of Waiver, Physician office05D1100593
Related
Questions
What is the CLIA number for Mact Medical San Andreas in San Andreas?
05D1084391, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Mact Medical San Andreas hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1084391 expire?
The CMS file lists May 20, 2028 as the certificate expiration date; the certificate took effect May 21, 2026.